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gtdac

Claim Closed - But Still Have Questions

Question

Hello everyone,

I am currently rated 90% due to a plethora of issues (ugh). However, I have one rating of 60% for Interstitial Lung Disease (ILD) which is a result of mixed connective tissue disease. Recently I filed a claim for an increase for ILD due to the usage of outpatient oxygen therapy and also for sleep apnea as a secondary to ILD. Long story short, the claim closed two-weeks ago and I was granted service connection for the sleep apnea as a secondary to ILD (but I will receive the 60% for the ILD because it's the higher of the two and pyramiding is not allowed). Additionally, the rating did not list any reference to the usage of outpatient oxygen therapy. How do I go back and ask for this to be readdressed? If I missed something that may be deemed important, I apologize in advance.

r,
Glen  

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@gtdac

It might depend on how they diagnosed the SA. It's kind of a weird rating because it also sits under the respiratory criteria because it impacts the respiratory system. Most of the time the VA considers it pyramiding with some other respiratory conditions, but there are a few cases where a separate rating can be applied. 

If the VA failed to consider oxygen use, my first recommendation is to check the rating criteria. Make your response easy for the VA to read. Spoon feed it to them. Quote the regulation/rating criteria, point back to your medical records showing you are on oxygen, and let them know you disagree with their prior decision.

Keep in mind that for rating increases, you can get a backdated effective date of up to 12 months if your evidence supports it.

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Did you get a varo decision?  If not wait for the envelope.  Once you get the decision you have some  choices:

1.   Appeal nothing.  There is nothing you need to do if you elect not to appeal.

2.  Appeal any/all of the following:

     a.  disability percentage(s), this can include SMC.  

     b.  effective dates.  

     c.  denial if some conditions were not service connected.  

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Vync, thanks for your response. I was informed that I should do a reconsideration and state the information that you provided above. Thanks again, Glen.

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broncovet, yes I did receive the VARO decision. I will probably submit a reconsideration and state that they did not provide utilize the evidence provided as it related to my claim. Thanks again, Glen.

 

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7 hours ago, gtdac said:

broncovet, yes I did receive the VARO decision. I will probably submit a reconsideration and state that they did not provide utilize the evidence provided as it related to my claim. Thanks again, Glen.

 

Not sure if I understand you statement ( they did not provide utilize the evidence as provided) 

But at any rate.. it is your responsibility to make sure they get the evidence that shows you are on  Home oxygen for the Interstitial Lung disease... if they already had the evidence, then there is a Clear & unmistakable error ( CUE) because Interstitial Lung disease with oxygen is a 100% rating.  You will only get one rating, and yes I know this sucks, because I have  Asthma/COPD and Sleep apnea, and I only get a single 100% rating because of oxygen use. ( Which doesn't seem right that three diseases are only rated once,   and technically sleep apnea is not even a respiratory  disease.) If it was just two ratings and one was rated 60% and the other 50% they would bump it to the next higher rating, but when your already at 100% there is no way to bump it up.

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